crossing96/oncoscreening huggingface dataset:
Machine Learning Accurately Predicts Muscle Invasion of Bladder Cancer Based on Three miRNAs.	The aim of this study was to validate the diagnostic potential of four previously identified miRNAs in two independent cohorts and to develop accurate classification models to predict invasiveness of bladder cancer. Furthermore, molecular subtypes were investigated. The miRNAs were isolated from pTa low-grade (lg) (n = 113), pT1 high-grade (hg) (n = 133) and muscle-invasive bladder cancer (MIBC) (n = 136) tumour tissue samples (FFPE) after either transurethral resection of a bladder tumour (TURB) or cystectomy (CYS). In both cohorts, the expression of miR-138-5p and miR-200a-3p was significantly lower, and the expression of miR-146b-5p and miR-155-5p was significantly higher in MIBC compared to pTa lg. A k-nearest neighbours (KNN) classifier trained to distinguish pTa lg from MIBC based on three miRNAs achieved an accuracy of 0.94. The accuracy remained at 0.91 when the classifier was applied exclusively to the TURB samples. To guarantee reliable predictions, a conformal prediction approach was applied to the KNN model, which eliminated all misclassifications on the test cohort. pT1 hg samples were classified as MIBC in 32% of cases using the KNN model. miR-146b-5p, miR-155-5p and miR-200a-3p expressions are significantly associated with particular molecular subtypes. In conclusion, we confirmed that the four miRNAs significantly distinguish MIBC from NMIBC. A classification model based on three miRNAs was able to accurately classify the phenotype of invasive tumors. This could potentially support the histopathological diagnosis in bladder cancer and therefore, the clinical decision between performing a radical cystectomy and pursuing bladder-conserving strategies, especially in pT1 hg tumors.	bladder
Impact of Tumor Stage on Oncologic Outcomes of High-grade Bacillus Calmette-Guérin Unresponsive Non-muscle-invasive Bladder Cancer Undergoing Bladder-sparing Therapies.	BACKGROUND AND OBJECTIVE: Current data on bacillus Calmette-Guérin (BCG)-unresponsive non-muscle-invasive bladder cancer (NMIBC) do not differentiate outcomes by clinical stage. The purpose of this study is to investigate the role of tumor stage in oncologic outcomes in BCG-unresponsive NMIBC undergoing bladder-sparing therapies. METHODS: Demographic and outcome data for patients with BCG-unresponsive NMIBC were reviewed at ten institutions. The Kaplan-Meier method was used to determine survival differences between the T1 ± carcinoma in situ (CIS), Ta alone, and CIS ± Ta groups. Exploratory analyses were conducted as follows: (1) T1 alone versus Ta alone versus CIS ± T1/Ta and (2) T1/Ta alone versus CIS ± T1/Ta. KEY FINDINGS AND LIMITATIONS: Among 401 patients, 137 (34%) were T1 ± CIS, 104 (26%) Ta alone, and 160 (40%) CIS ± Ta. Disease progression (p < 0.001), metastasis (p < 0.001), and bladder cancer mortality (p = 0.009) were increased in the T1 ± CIS group versus the Ta alone and CIS ± Ta groups. Cystectomy occurred most often in the CIS ± Ta and T1 groups (p = 0.002). Similar increases were noted in progression (p < 0.001), metastasis (p < 0.001), and bladder cancer mortality (p = 0.004) in T1 alone patients versus the Ta alone and CIS ± T1/Ta groups. There were no differences in outcomes between the T1 alone and T1 + CIS groups. No significant differences in metastasis, bladder cancer mortality, or all-cause mortality were noted when comparing papillary disease only with any CIS. The primary limitation of this study is likely a selection bias due to the retrospective nature of the cohort. CONCLUSIONS AND CLINICAL IMPLICATIONS: Presence of T1 disease is generally associated with worse oncologic outcomes compared with Ta or CIS. T1 and Ta should not be grouped together during comparison with CIS. Radical cystectomy appears largely driven by the presence of CIS.	bladder
Clinical outcomes of nephroureterectomy with bladder cuff excision or radical cystectomy for distal ureteral carcinoma invaded muscle of the ureteral orifice.	PURPOSE: To present the clinical outcomes of nephroureterectomy with bladder cuff excision (NU-BCE) or radical cystectomy (NU-RC) when distal ureteral carcinoma invaded muscle of the ureteral orifice using inverse probability of treatment weighting (IPTW). METHODS: This multicenter study retrospectively studied the demographics and perioperative outcomes of 59 patients who underwent NU-BCE or NU-RC between 2003 and 2024. Relapse-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were presented using Kaplan-Meier curves. Cox proportional hazard regression to find independent predictors. RESULTS: Of all patients, the median follow-up time for RFS was 8 months and 18 months for CSS and OS. After IPTW, the median RFS, CSS, and OS for patients who underwent NU-BCE and NU-RC was 9 vs. 27 months (p = 0.037), 18 vs. 40 months (p = 0.027), 18 vs. 30 months (p = 0.371), respectively. The mortality due to progression and complications in NU-BCE and NU-RC patients were 56.4% vs. 20.4% and 2.2% vs. 22.9% (p = 0.016). NU-BCE reduced the median operation time, blood loss, and drainage volume. Apart from NU-RC (HR, 0.18; 95%CI: 0.08-0.44; p < 0.001) (HR, 0.28; 95%CI: 0.1-0.79; p = 0.016) and tumor volume(HR, 1.17; 95%CI: 1.06-1.29; p = 0.002) (HR, 1.21; 95%CI: 1.11-1.31; p < 0.001), which are independent prognostic factors for RFS and CSS, another independent prognostic factor for CSS is the ureteral carcinoma with renal pelvic carcinoma (HR, 4.32; 95%CI: 1.28-14.511; p = 0.018). CONCLUSIONS: Patients who underwent NU-RC had better RFS and CSS than NU-BCE, but there was little difference in OS due to the higher mortality rate of postoperative complications in the NU-RC.	bladder
Temozolomide as neoadjuvant therapy for bladder paraganglioma.	Bladder Paraganglioma (BPG) is a rare form of pheochromocytoma and paraganglioma (PPGL) characterized by elevated blood pressure when urinating, headache, dizziness, palpitations, and hematuria. Surgical resection is the most commonly used treatment for BPG. Here, we reporte a man who initially presented with hypogastralgia and hematuria and was diagnosed as BPG at local hospital. The size of mass was too huge to receive partial cystectomy at diagnosis. Then this patient was referred to our medical center. After evaluation, we chose temozolomide as neoadjuvant therapy to reduce the tumor size. Followed by seven cycles of temozolomide, the tumor was decreased and was successfully removed via partial cystectomy.	bladder
The usefulness of transarterial embolization before transurethral resection of bladder tumor for patients with large bladder tumors.	OBJECTIVE: To assess the usefulness of transarterial embolization (TAE) before a transurethral resection of bladder tumor (TURBT) procedure for large bladder tumors, intra- and postoperative outcomes were retrospectively compared between patients with and without TAE before TURBT. METHODS AND RESULTS: Thirty-seven patients underwent TURBT for complete resection of bladder tumors with a diameter of 3 cm or greater between January 2013 and December 2023 at the Department of Urology, Hyogo Medical University. For 13, TAE was performed 1 or 2 days before TURBT. In the TAE group, tumor volume was significantly larger [74.1 ± 42.7 (28.9-190.5) cm(3) vs. 17.3 ± 14.3 (6.1-69.8) cm(3), p < 0.05] and operative time significantly shorter [119 ± 49.8 (74-263) min vs. 143 ± 28.1 (107-218) min, p = 0.012] as compared with the non-TAE group. Furthermore, the change in hemoglobin level was significantly less in the TAE group [-0.6 ± 0.8 (0.4 to -2.3) mg/dL vs. -1.0 ± 0.7 (0.1 to -3.1) mg/dL, p = 0.008]. CONCLUSION: TAE before TURBT for a large bladder tumor contributes to less blood loss and shorter operative time, thus allowing resection to be performed safely without serious complications.	bladder
[The Case of Solitary Adrenal Metastasis of Urothelial Carcinoma].	A 79-year-old woman underwent radical cystectomy after neoadjuvant chemotherapy for urothelial carcinoma of bladder (high grade, pT3aN0M0). Six months later, a computed tomography scan revealed multiple lung metastases. Salvage treatment with chemotherapy and pembrolizumab was administered, and a complete response was achieved. Two years after surgery, however, a left adrenal mass appeared, and positron emission tomography／computed tomography showed significant solitary uptake in the left adrenal gland. She underwent left adrenalectomy and histological findings revealed that the adrenal tumor was a metastatic urothelial carcinoma. No new lesion was observed over one year after surgery. Surgical resection should be considered in cases with solitary metastasis who responded systemic treatment.	bladder
Evaluation of Melanoma and Bladder Cancers in New Hampshire to Identify Registrar Training Needs.	BACKGROUND: The New Hampshire State Cancer Registry (NHSCR) conducts recoding audits as resources allow to identify areas for quality improvement. Utilizing the National Program of Cancer Registries (NPCR) data quality evaluation (DQE) framework, the NHSCR conducted a selective recoding audit for melanoma of skin and bladder cancers diagnosed in 2018 to identify challenges and implement training for hospital registrars. PURPOSE: The DQE can help determine whether central registries need to incorporate additional training for their reporters. METHODS: The NHSCR performed a recoding audit on random samples of melanomas of skin and urinary bladder cancers diagnosed in 2018. The audit included a review of data items with the lowest accuracy found on the national DQE and 3 additional data items recommended for review based on the national DQE findings. RESULTS: Accuracy rates were calculated on the quality of data items after performing follow-back to reporting sources to address discrepancies that were identified. Data items for melanomas of skin included tumor size summary, date of first course treatment, and treatment summary-surgery of primary site. Data items for urinary bladder cancers included grade clinical and grade pathological. The 3 additional data items include diagnosis date, histology, and date of first surgical procedure. DISCUSSION: Results from the recoding audit will be used to address training needs for New Hampshire cancer registrars.	bladder
Investigating the Potential to Offer Reproductive Organ Preserving Radical Cystectomy to More Female Bladder Cancer Patients.	INTRODUCTION: Traditional radical cystectomy (tRC) in female bladder cancer (BC) patients includes removal of the ovaries, uterus, and anterior vaginal wall. Reproductive organ preserving radical cystectomy (ROPRC) offers less invasive surgery with comparable survival and better functional outcomes for selected patients. The objective of this study is to investigate the current number of ROPRC at our institution and the potential for increased adoption of the procedure based on precystectomy assessment criteria. PATIENTS AND METHODS: A retrospective cohort study of female patients treated with radical cystectomy between 2017 and 2021 at a single high volume academic center in Denmark. Suspicion of stage T4 was assessed based on precystectomy CT, transurethral resection of bladder tumor with bimanual palpation, and intraoperative assessment at cystectomy. Median follow-up was 36 months for both tRC and ROPRC. The primary outcome was number of ROPRC. The secondary outcome was potential for ROPRC in the tRC population. Frequencies and predictive values were calculated. RESULTS: A total of 118 female BC patients were included. Four patients underwent ROPRC, all with non-muscle-invasive BC. None had local recurrence. In tRC (n = 114), stage T4 BC was suspected in 31% (35/114) and 14% (16/114) had pT4 at final pathology. There was no suspicion of stage T4 BC in 83 patients, and 82 of these had <pT4 at final pathology, providing a negative predictive value for identifying stage T4 BC before pathology of 99%. The potential for ROPRC in the tRC population was 69% (79/114). Limitations were the retrospective single center study and limited number of ROPRC. CONCLUSIONS: Only 4 women over a 5-year period underwent complete or partial ROPRC. The preoperative prediction of stage T4 was accurate, which could reflect a potential to offer ROPRC to more than two thirds of female cystectomy patients currently undergoing tRC.	bladder
Proteomic profiling identifies muscle-invasive bladder cancers with distinct biology and responses to platinum-based chemotherapy.	Platinum-based neoadjuvant chemotherapy prior to radical cystectomy is the preferred treatment for muscle-invasive bladder cancer despite modest survival benefit and significant associated toxicities. Here, we profile the global proteome of muscle-invasive bladder cancers pre- and post-neoadjuvant chemotherapy treatment using archival formalin-fixed paraffin-embedded tissue. We identify four pre-neoadjuvant chemotherapy proteomic clusters with distinct biology and response to therapy and integrate these with transcriptomic subtypes and immunohistochemistry. We observe proteomic plasticity post-neoadjuvant chemotherapy that is associated with increased extracellular matrix and reduced keratinisation compared to pre-neoadjuvant chemotherapy. Post-neoadjuvant chemotherapy clusters appear to be differentially enriched for druggable proteins. For example, MTOR and PARP are over-expressed at the protein level in tumours identified as neuronal-like. In addition, we determine that high intra-tumoural proteome heterogeneity in pre-neoadjuvant chemotherapy tissue is associated with worse prognosis. Our work highlights aspects of muscle-invasive bladder cancer biology associated with clinical outcomes and suggests biomarkers and therapeutic targets based on proteomic clusters.	bladder
Tissue-Based Biomarkers Important for Prognostication and Management of Genitourinary Tumors, Including Surrogate Markers of Genomic Alterations.	A better understanding of the molecular alterations that underlie urologic malignancies and advances in targeted therapies has impacted classification, prognostication, and treatment. In bladder tumors, these advances include the development of antibody-drug conjugates targeting nectin-4 and Trop-2, as well as human epidermal growth factor receptor 2 and immunotherapy. In prostate cancer, assessment of the percentage of Gleason pattern 4, presence of cribriform glands, and molecular alterations, including PTEN and mismatch repair protein loss, have become standard for clinical care. In renal malignancies, alterations in TSC1/2, mammalian target of rapamycin, anaplastic lymphoma kinase, and other genes impact classification and therapeutic decisions.	bladder
Epithelial cell diversity and immune remodeling in bladder cancer progression: insights from single-cell transcriptomics.	BACKGROUND: The progression of bladder cancer (BC) from non-muscle-invasive bladder cancer (NMIBC) to muscle-invasive bladder cancer (MIBC) significantly increases disease severity. Although the tumor microenvironment (TME) plays a pivotal role in this process, the heterogeneity of tumor cells and TME components remains underexplored. METHODS: We characterized the transcriptomes of single cells from 11 BC samples, including 4 NMIBC, 4 MIBC, and 3 adjacent normal tissues. Bulk RNA-seq data were used to validate the clinical features of characteristic cells, and protein levels of these cells were further confirmed through immunohistochemistry (IHC) and multiplex immunofluorescence. RESULTS: Bladder cancer progression was associated with distinct transcriptomic features in the TME. Tumor cells in MIBC displayed enhanced glycolytic activity and downregulation of chemokines and MHC-II molecules, reducing immune cell recruitment and facilitating immune evasion. This highlights glycolysis as a potential therapeutic target for disrupting tumor progression. We identified a T cell exhaustion pathway from naive CD8 + T cells (CD8 + TCF7) to terminally exhausted CD8 + STMN1 cells, with progressively declining immune surveillance. Targeting intermediate exhaustion states may restore T cell function and improve anti-tumor immunity. Macrophages polarized toward a pro-tumorigenic phenotype, while VEGFA + mast cells promoted angiogenesis in early-stage BC, suggesting their role as potential targets for therapeutic intervention in NMIBC. Furthermore, conventional dendritic cells (DCs) transformed into LAMP3 + DCs, contributing to an immunosuppressive microenvironment and enabling immune evasion. CONCLUSION: This study reveals dynamic changes in the TME during BC progression, including enhanced glycolysis, T cell exhaustion, and immune cell remodeling, which contribute to immune evasion and tumor progression. These findings identify critical pathways and cell populations as potential therapeutic targets, offering new strategies to improve treatment outcomes in BC patients.	bladder
Urinary DNA Methylation Test for Bladder Cancer Diagnosis.	IMPORTANCE: An accurate noninvasive biomarker test is needed for the early diagnosis of bladder cancer. OBJECTIVE: To evaluate the performance of a urinary DNA methylation test (PENK methylation) and compare its diagnostic accuracy with that of the nuclear matrix protein 22 (NMP22) test or urine cytology test. DESIGN, SETTING, AND PARTICIPANTS: In this prospective multicenter study at 10 sites in the Republic of Korea, individuals 40 years and older with hematuria undergoing cystoscopy within 3 months between March 11, 2022, and May 30, 2024, participated. The study participants were evaluated for bladder cancer using a urinary DNA methylation test. EXPOSURE: Urinary DNA methylation test, NMP22 test, and urine cytology test. MAIN OUTCOMES AND MEASURES: The primary outcomes were the sensitivity and specificity of the urinary DNA methylation test for high-grade or invasive bladder cancer. Secondary objectives included the accuracy of the test for overall bladder cancer (all stages and grades) and the comparison of sensitivities and specificities for bladder cancer between the urinary DNA methylation test and the NMP22 test or urine cytology test. RESULTS: Among the 1099 participants, 614 (55.9%) were male; participants had a mean (SD) age of 65 (10) years. Of the 1099 participants, 219 and 176 participants had bladder cancer and high-grade or invasive bladder cancer, respectively. The urinary DNA methylation test had sensitivity and specificity for high-grade or invasive bladder cancer of 89.2% (95% CI, 84.6%-93.8%) and 87.8% (95% CI, 85.6%-89.9%), respectively. Sensitivity and specificity for overall bladder cancer were 78.1% (95% CI, 72.6%-83.6%) and 88.8% (95% CI, 86.7%-90.8%), respectively. The positive predictive value for high-grade or invasive bladder cancer was 61.3% (95% CI, 55.4%-67.3%), and the negative predictive value was 97.6% (95% CI, 96.6%-98.7%). In comparison with the NMP22 test or urine cytology test, the urinary DNA methylation test showed significantly superior sensitivity for high-grade or invasive bladder cancer and overall bladder cancer. CONCLUSIONS AND RELEVANCE: In this prospective multicenter study of individuals with hematuria, the urinary DNA methylation test showed 89% sensitivity for detecting high-grade or invasive bladder cancer, outperforming the NMP22 test or urine cytology test with high specificity. While this test had an excellent negative predictive value, its positive predictive value was suboptimal.	bladder
Natural compounds as modulators of miRNAs: a new frontier in bladder cancer treatment.	Bladder cancer (BC) is a major global health issue with a high recurrence rate and limited effective treatments. Over the past few years, it has become evident that miRNAs play a role in the carcinogenesis process, particularly in regulating genes that promote cancer cell proliferation and invasion. This review focuses on the extent to which natural products can act as potential miRNA modulators for the management of bladder cancer. Polyphenols, flavonoids, and other phytochemicals are natural compounds found to have inherent potential to modulate miRNAs and reform the oncogenic properties of bladder cancer cells regulating cell growth and death. In integration with the current cancer treatment regimes, such natural agents may safely substitute for the traditional chemical chemotherapeutic agents of the conventional approaches. To this end, this review presents the existing knowledge of natural compounds as regulators of miRNA, their mechanisms for the management of BC, the role of their nanoparticles, and future novel therapies. The use of these compounds is not only a therapeutic practice for the conditions of bladder cancer, but it also upholds new avenues for creativity.	bladder
Utility of MRI in NMIBC and feasibility of avoiding Re-TURB in carefully selected patients: a systematic review.	OBJECTIVE: This systematic review was conducted to synthesize current research on the role of repeated transurethral resection of the bladder (re-TURB) and the emerging use of magnetic resonance imaging (MRI) in discerning patient suitability for safely foregoing this procedure. EVIDENCE ACQUISITION: Employing a methodical literature search, we consulted several bibliographic databases including PubMed, Science Direct, Scopus, and Embase. The review process adhered strictly to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. EVIDENCE SYNTHESIS: We evaluated data from 667 patients (mean age 65.8 years; age range 59-75 years) who underwent MRI prior to potential re-TURB. The gap between initial TURB and MRI was reported as 42 days in one study, while the interval between MRI and subsequent cystoscopy, with or without biopsy, varied from 21 days to 3 months. Initial TURB pathology for non-muscle invasive bladder cancer (NMIBC) patients identified stage Ta in 177 (42.5%) and T1 in 246 (57.5%) patients across three studies. High-grade and low-grade pathologic classifications were reported in 377 (64.5%) and 207 (35.5%) patients respectively in two studies. The VI-RADS scoring system's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the detection of bladder cancer recurrence were 89%, 85.5%, 82.7%, and 96%, respectively. A total of 365 patients (54.7%) underwent re-TUR. Among NMIBC patients, re-TUR pathology revealed Ta in 22 cases (5.4%) and pT1 in 179 cases (44%) with VI-RADS 1-2, while no cases of Ta (0%) and 37 cases of T1 (9%) were reported with VI-RADS 4-5, as documented in two studies. Notably, only 69 patients (10.7%) were identified as having MIBC across all studies. CONCLUSION: MRI is demonstrating reliability as a diagnostic tool for non-muscle invasive bladder cancers. The VI-RADS scoring system appears to be a promising approach in selecting patients for re-TURB. DW-MRI may serve as a primary diagnostic examination for patient follow-up post-TURB.	bladder